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Abstract

Introduction: Fatty acid binding protein 4 (FABP4), a cytosolic FA chaperone abundantly expressed in adipocytes and macrophages, has been implicated in the development of atherosclerosis in metabolic disease. Pericardial adipose tissue (PAT) may play a role in coronary atherosclerosis. In this study, we examine the association between serum FABP4 levels, PAT, and several surrogate markers for plaque vulnerability (positive remodeling (PR), spotty calcification, and low attenuation) in patients with type 2 diabetes.

Results: Circulating FABP4 but not other biomarkers (leptin, adiponectin, iInterleukin-6, TNF-alpha, AGE and RAGE) were positively correlated with PAT volume (R=0.576, P<0.01). Serum FABP4 were not significantly different between the patients with and without significant stenosis. FABP4 levels was significantly lower in the patients with PR than those in the patients without PR (18.4 ± 8.4 vs 13.8 ± 5.9, P<0.05). Interestingly, in the patients with PR, PAT volume (92.0 ± 38.5 vs 153.3 ± 42.6, p<0.01), and serum FABP4 levels (9.2 ± 3.6 vs 16.7 ± 5.2, p<0.01) were significantly higher in the patients with low attenuation plaques (LAP).

Conclusion: Increased circulating FABP4 are positively associated with PAT volume and the presence of low attenuation plaques while they are inversely associated with PR in patients with type 2 diabetes. These findings suggest that therapeutic intervention aimed at lowering serum FABP4 levels may represent the potentially interesting approach to the stabilization of the plaques without causing negative remodeling in type 2 diabetic patients.